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Introduction <p>We utilized the Veterans Affairs Healthcare System administrative database to study the clinical decision-making processes for anti-amyloid therapy (AAT).</p> Methods <p>Patients with clinical notes mentioning lecanemab were identified (March 2023–June 2024) for manual review and structured database queries.</p> Results <p>From an initial sample (<i>N</i>&#xa0;=&#xa0;2499), 1064 patients (55,000 notes) were reviewed manually (mean age 76 years; 7.3% women; 9.2% Black; 3.9% Hispanic). The AAT group (<i>n</i>&#xa0;=&#xa0;56) had lower rates of common comorbidities, except post-traumatic stress disorder, than patients excluded from AAT (<i>n</i>&#xa0;=&#xa0;528). The documented notes including “Lack of patient interest/resource constraints” (24.6% vs 3.6%), “anticoagulant use” (23.1% vs 10.7%), and “advanced AD” (18.6% vs 0), supplied partial explanations on exclusion vs inclusion.</p> Discussion <p>Only 5.3% of patients reached the point of care of being a candidate, scheduled for, or receiving AAT infusion. Patient preference and clinician discretion, especially regarding modifiable factors (e.g., medication regimens), appreciably influence the patient journey to AAT.</p>

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Patient journey and decision processes for anti-amyloid therapy in Alzheimer’s disease

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年4月16日

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  • Brant Mittler,
  • Xavier Cambi,
  • Morgan Biskach,
  • Joel Reisman,
  • Ying Wang,
  • Dan Berlowitz,
  • Peter Morin,
  • Donald R. Miller,
  • Karla Brandao-Viruet,
  • Sophie J. Clare,
  • Kevin Z. Xia,
  • Amir Abbas Tahami Monfared,
  • Michael Irizarry,
  • Quanwu Zhang,
  • Weiming Xia

摘要

Introduction

We utilized the Veterans Affairs Healthcare System administrative database to study the clinical decision-making processes for anti-amyloid therapy (AAT).

Methods

Patients with clinical notes mentioning lecanemab were identified (March 2023–June 2024) for manual review and structured database queries.

Results

From an initial sample (N = 2499), 1064 patients (55,000 notes) were reviewed manually (mean age 76 years; 7.3% women; 9.2% Black; 3.9% Hispanic). The AAT group (n = 56) had lower rates of common comorbidities, except post-traumatic stress disorder, than patients excluded from AAT (n = 528). The documented notes including “Lack of patient interest/resource constraints” (24.6% vs 3.6%), “anticoagulant use” (23.1% vs 10.7%), and “advanced AD” (18.6% vs 0), supplied partial explanations on exclusion vs inclusion.

Discussion

Only 5.3% of patients reached the point of care of being a candidate, scheduled for, or receiving AAT infusion. Patient preference and clinician discretion, especially regarding modifiable factors (e.g., medication regimens), appreciably influence the patient journey to AAT.